Diet and clinical remission in patients with inflammatory bowel disease: A multicenter cross-sectional study

Abstract

Background: Diet and risk of developing inflammatory bowel disease (IBD) has been extensively studied.

Aims: To investigate the association between diet and IBD activity.

Methods: Consecutive outpatients in 40 French and Belgian centers completed diet and IBD activity questionnaire between April and May 2023 in a cross-sectional study. Associations between diet and clinical remission were adjusted for gender, age, body mass index, education, smoking, and past CD-surgery.

Results: Among 2514 patients included, 1715 had Crohn's disease (CD) and 799 had ulcerative colitis (UC). Overall, the mean age was 42.4 years, 52.3 % were women, and 56.4 % were in clinical remission. Among CD patients, clinical remission was associated with a higher intake of fruits (aOR 1.60 [1.20-2.14]) and coffee (aOR 1.57 [1.17-2.11]). Among UC patients, clinical remission was associated with a higher intake of fruits (aOR 1.72 [1.15-2.56]) and salad (aOR 1.73 [1.12-2.66]). A higher adherence to a Mediterranean diet was associated with CD (aOR 1.39 [1.06-1.84]) but not UC remission. A higher adherence to a healthy diet was not associated with either CD nor UC remission.

Conclusions: CD remission was associated with higher intakes of fruits, coffee and a Mediterranean diet, while UC remission was associated with higher intakes of fruits and salad. As this was a cross-sectional study, the main limitation was the possibility of reverse causality.

Keywords: Clinical remission; Diet; Inflammatory bowel disease; Mediterranean diet.